Kornimate/medical-research-clean huggingface dataset:
eswl versus eswl and endoscopic treatment

Conditions: Pancreatitis

Summary: the study wants to compare eswl alone with eswl and endoscopic drainage of the mpd for treatment of pain in chronic pancreatitis.

the combination mode of eswl and ercp is an established method of treatment of painful obstructive calcified chronic pancreatitis. however, the investigators notice that patients after eswl alone in calcified cp is followed by spontaneous elimination of stone fragments and pain relief. inui reported that 40% of 555 patients spontaneous eliminate stone fragments. dumonceau found that combining systematic endoscopy with eswl adds to the cost of patient care, without improving the outcome of the pancreatic pain. so the investigators design such a prospective and randomized controlled trial. people diagnosed with uncomplicated painful chronic pancreatitis and calcifications obstructing the mpd will be randomly assigned to the eswl or endoscopy group according to a table of random numbers. eswl will be performed in all patients using a electromagnetic lithotriptor. eswl sessions will be repeated if necessary, until stone fragmentation is obtained. patients in the endoscopy group will undergo endoscopy in 48 hours with possible stent insertion. in the eswl group, if pain continues or aggravates, endoscopic drainage of the mpd will be carried out. follow-up will consists of telephone interview1 after treatment and clinical examination every 6 months thereafter. data collected will include clinical presentation, eswl, endoscopic and surgical procedures, life quality. in addition, s-mrcp will be performed 6 months after treatment. blood glucose, insulin, stool elastase will be taken each clinical examination.

Eligibility criteria:
inclusion criteria: * painful chronic pancreatitis(abdominal pain attack during the preceding 12 months); * at least 1 calcified stone greater than 5 mm in one of its axes in the cephalic or corporeal portion of the main pancreatic duct with upstream duct dilation; * no ercp or eswl carried out before admission exclusion criteria: * suspected to have malignant tumors; * history of pancreatic surgery or gastrojejunostomy (billroth ii); * pancreatic collection greater than 2 cm in diameter at magnetic resonance or ct scan; * age below 18 years; * pregnancy or lactation; * refuse to write informed consent

Keywords: extracorporeal shock wave lithotripsy(eswl) endoscopic retrograde cholangiopancreatography(ercp) chronic pancreatitis pain relief
efficiency of negative pression therapy with instillation in the debridement of wound

Conditions: Wound

Summary: the aim of the study is to evaluate the efficiency of the therapy with negative pression (tpn) and instillation in the debridement of chronic wound

it is an observation study with only the aim to evaluate the percentage of fibrin before and after the specific treatment of tpn

Eligibility criteria:
inclusion criteria: * wound with debridement exclusion criteria: -
modified fraility index in patients undergoing arthroplasty

Conditions: Frailty Syndrome; Postoperative Complications

Summary: the authors aimed to evaluate the relation between modified fraility index (mfi) and postoperative complications (myocardial infarction, cardiac arrest, pulmonary embolism, septic shock, postoperative dialysis requirement, cerebrovascular event, reintubation, prolonged mechanical ventilation, surgical wound complications), duration of hospitalization, requirement for intensive care unit (icu) admission and rehospitalization and 30th day mortality in patients undergoing arthroplasy.

fraility index is calculated according to 70 parameters which are present in national surgical quality improvement programme (nsqip) of american college of surgeons. this model defines fraility as a cumulative effect of individual defects depending on clinical symptoms, disease states and disabilities which provides more accurate evaluation of aging. these 70 parameters present in nsqip database were matched with 11 variables to create a modified fraility index. there are 11 parametres in modified fraility index (mfi) (exacerbation of chronic obstructive pulmonary disease or history of pneumonia (within last 30 days), exacerbation of congestive heart failure (within last 30 days), diabetes mellitus, dependant functional status (partially or totally dependant), history of angina, percutaneous coronary intervention or coronary bypass grefting) (within last 30 days), medically treated hypertension, acute impaired sensorium, history of peripheral vascular disease, history of myocardial infarction (within last 6 months), cerebrovascular disease with neurological deficit, cerebrovascular disease without neurological deficit or transient ischemic attack (tia). presence of one of the above mfi parameters has taken 1 point. the total point that each individual achieved according to the presence of the parameters is calculated and the total score divided by 11 is defined as mfi value. 145 patients aged between 45-85 who had undergone primary or revision total knee and hip arthroplasty were included to the current prospective study. in all patients mfi was calculated. patients were classified as nonfrail (mfi\<0,27), and frail patients (mfi≥0.27) according to mfi value. all patients were followed up for 30 days during postoperative period. the presence of myocardial infarction, cardiac arrest, pulmonary embolism, septic shock, postoperative dialysis requirement, cerebrovascular event, reintubation, reoperation, prolonged mechanical ventilation, surgical wound complications; duration of hospitalization; requirement for intensive care unit (icu) admission and rehospitalization and 30th day mortality were questioned.

Eligibility criteria:
inclusion criteria: patients aged between 45-85 undergoing primary or revision total knee and hip arthroplasty exclusion criteria: emergent surgery, patients aged below 45 and above 85, patients with cognitive dysfunction

Keywords: arthroplasty, fraility
low field magnetic stimulation: open label study.

Conditions: Mood Disorders; Anxiety

Summary: to assess the effects of daily lfms treatments for those suffering from affective or anxiety symptoms. we hypothesize a reduction in affective and or anxiety symptoms after active treatment over the period of one week, with improvement through the following week.

the low field magnetic stimulation (lfms) procedure is an application of a series of electromagnetic pulses to the brain. the field and timing parameters of the lfms pulses, such as pulse timing, duration, frequency, and electric and magnetic field distribution and direction are different from other neurostimulation methods. lfms electromagnetic fields are significantly weaker (\< 100x) than those used in ect and rtms. lfms was discovered at mclean hospital and has thus far been studied as an experimental antidepressant treatment at mclean hospital. lfms is also being studied at massachusetts general hospital and 5 other hospitals in an nih sponsored trial (rapid) as well as in studies at cornell-weill school of medicine. the mechanism of action for the antidepressant effects of lfms is hypothesized to be an interaction between the electromagnetic fields and neurons in cortical regions, brought about by low level electrical stimulation applied with particular timing. the current study proposes to assess the effects of daily lfms treatments in participants suffering from affective disorders and/or anxiety. this is an open-label study. all subjects will receive active lfms treatments. potential subjects will be referred to the study by their clinicians and will be pre-screened by phone.

Eligibility criteria:
inclusion criteria: 1. subjects will be accepted into the study upon written referral by a mclean clinician or outside psychiatrist. 2. subjects will be men or women over the age of 18. 3. subjects must have failed at least one fda approved treatment before enrolling in this study. 4. subjects must be capable of providing informed consent. 5. subjects must have either a hamilton depression rating scale (hdrs) score \> 14 indicating moderate depression or hamilton anxiety rating scale (hars) score \> 18 indicating moderate anxiety. exclusion criteria: 1. dangerous or active suicidal ideation. 2. pregnant or planning on becoming pregnant. 3. recent history (within 3 days) of ect or tms treatment. 4. substance abuse (cannot meet dsm criteria for substance abuse, no significant drug abuse within last 3 months, no history of dependence in last year, no drug use within last month, other than marijuana use). 5. current psychosis. 6. contraindications for mri: presence of a pacemaker, neurostimulator, or metal in head or neck. 7. "do not resuscitate" order in place (to avoid risk in the case of non-study-related accidents). -
observational study of safety of novomix® 30 treatment for type 2 diabetes

Conditions: Diabetes; Diabetes Mellitus, Type 2

Summary: this trial is conducted in europe. the aim of this trial is to evaluate the incidence of serious adverse drug reactions when initiating insulin therapy with novomix® 30 in subjects with type 2 diabetes mellitus under normal clinical practice conditions in sweden.


Eligibility criteria:
inclusion criteria: * subjects with type 2 diabetes
3d volumetric changes in the upper airway after mma in osas patients and the implication on qol: a prospective registry

Conditions: Obstructive Sleep Apnea

Summary: background obstructive sleep apnea syndrome (osas) is a sleep-related breathing disorder characterized by intense snoring and repetitive complete or partial obstructions of the upper airway during sleep together with daytime sleepiness. several non-invasive therapeutical options exist, however, they do not offer a permanent improvement. maxillomandibular advancement (mma) surgery is a procedure which changes the upper airway in a permanent way. objectives the investigators aim to develop a prospective database registering 3d volumetric changes of the upper airway and its anatomic subregions, the apnea-hypopnea index (ahi) and quality of life (qol) of all consecutive patients eligible for mma, performed by dr. neyt. patient demographics, detailed virtual cone-beam computed tomography (cbct) planning parameters, orthognathic surgery, polysomnographic and qol data are being collected during consecutive visits within the framework of routine practice. design a prospective, observational cohort study study center general hospital (az) sint-jan brugge-oostende population the investigators would like to include all osas patients (ahi ≥ 5) requiring a mma by dr. neyt starting from january 2015. endpoints the investigators aim to collect data that could provide information about the advantages and disadvantages of the routinely performed 3d cbct preoperative mma surgery planning for osas patients, regarding 3d volumetric changes of the upper airway and its anatomic subregions and quality of life (qol) in a subjective manner with the epworth sleepiness scale (ess) and the osas questionnaire and in an objective manner with evaluation of the apnea-hypopnea index (ahi). duration in light of the continuous improvement of patient care, a database will be maintained from january 2015 onwards to enable registration of large-scale osas patient data. conclusions development of a database registering 3d cbct planning, polysomnographic data and quality of life (qol) of all consecutive patients eligible for mma, will provide more information about potential patient, virtual planning and surgical factors influencing accuracy of mma, and the associated biological benefits of this procedure on the upper airway volume, the ahi and general qol. moreover, registration of those results could function as a measurement of quality of care, or could be used for sample size calculation for future large multicenter prospective trials.


Eligibility criteria:
inclusion criteria: * patients of all ages * patients of all genders * patients diagnosed with osas, based on an ahi ≥ 5 * all consecutive osas patients operated by n. neyt from january 2015 onwards exclusion criteria: * patients not eligible according to abovementioned criteria * patients with morbid obesity (bmi \>35), if judged non-eligible by the treating surgeon

Keywords: maxillomandibular advancement obstructive sleep apnea apnea-hypopnea index quality of life
discharge planning in emergency department for frail older with ahf

Conditions: Acute Heart Failure; Frail Elderly Syndrome

Summary: objectives: to demonstrate the efficacy of care transition holistic intervention (multilevel guided discharge planning, mgdp) in reducing 30-day adverse outcomes among frail older patients with acute heart failure (ahf) discharged from emergency departments (eds) and to validate the results of mgdp in real life. method: investigators will select frail patients ≥70 years with primary diagnosis of ahf discharged from eds. the intervention will consist of mgdp implementation: 1) checklist that includes clinical recommendations and resources activations; 2) scheduling of early visit with the specialist; 3) communication with primary care; 4) providing a written instruction sheet to patient or caregiver. phase 1: matched-pair cluster randomized clinical trial. eds were randomly allocated to intervention (n = 10) or control (n = 10) group. investigators will compare the outcomes between intervention and control groups. phase 2: a quasi-experimental study. the 20 eds will carry out the intervention. investigators will compare the outcomes between phase 1 and phase 2 of intervention group and between phase 1 and phase 2 of control group. the main outcome is a 30-day composite endpoint (ed revisit or hospital admission for ahf and cardiovascular death) after being discharged.


Eligibility criteria:
inclusion criteria: * age ≥70 years. * diagnosis of descompensated chronic heart failure. * screening for frailty positive (isar ≥ 2). * planned discharge home from emergency department (included observation and short stay unit). * written informed consent provided by the patient or proxy. exclusion criteria: * de novo (new onset) acute heart failure (ahf). * severe episode of acute heart failure (≥9th decile of meessi-ahf score). * uncorrected clinically significant primary valvular disease. * acute coronary syndrome currently or within 30 days prior to enrolment. * surgery or implanted device within 30 days prior to enrolment. * significant arrhythmias. * uncorrected systolic blood pressure \ 110 bpm, serum sodium \ 5,5 mmol/l or hemoglobin \<9 g/dl prior to enrolment. * planned treatment with vasoactive therapies, ventricular assist device, heart surgery or transplant within 6 months. * end stage renal disease. * severe disability. * difficulty intervention due to significant dementia, active delirium or psychiatric disorder. * condition with a life expectancy \<1 year. * length of stay in emergency department ≥96 hours. * discharged to facility care. * inability of outpatient follow-up.

Keywords: discharge planning emergency department heart failure older frail
registration study of amyotrophic lateral sclerosis (als) in mainland china

Conditions: Amyotrophic Lateral Sclerosis

Summary: a multi-center registration study of natural history and clinical characteristics of als in mainland china

amyotrophic lateral sclerosis (als) is a rapidly progressive neurodegenerative disease of unknown etiology that is currently incurable. this study is a national multi-center registration study. the study collects general information of als patients including medical history, disease characteristics, clinical treatment data, and patient information for different visits in different centers. the aim of the study is: a) describe the distribution of als in mainland china(explore the differences in the number of als at different times, different regions, and different populations) and further find the reasons that affect the distribution of als, b) study the development of als in mainland china and the corresponding changes in the characteristics of the disease, c) explore factors that influence the prognosis of als.

Eligibility criteria:
inclusion criteria: * clinical diagnosis of laboratory-supported probable, probable, or definite als according to ei escorial diagnostic criteria * age: 18-70 years exclusion criteria: * refuse to cooperate or reject the informed consent
stepwise approach versus linear ablation in patients with recurrence of persistent atrial fibrillation

Conditions: Atrial Fibrillation; Recurrence

Summary: catheter ablation of persistent atrial fibrillation (af) remains a challenging procedure. even in experienced centres, repeat interventions are necessary in up to 70 of patients to achieve sinus rhythm at a long-term follow-up. while there is a consensus to perform pulmonary vein isolation (pvi) as a cornerstone for the ablation of paroxysmal and persistent af ablation, different additional ablation strategies are used to achieve a modification of the substrate that perpetuates the arrhythmia: linear lesions (anterior and roof lines) or ablation of complex fractionated atrial electrograms (cfae). in the stepwise approach pvi, cfae ablation and/or ll are combined according to the presenting arrhythmia during procedure. the aim of the study is to determine whether there is a difference in terms of freedom from arrhythmia between a stepwise approach and a linear ablation for repeat procedure in patient with recurrence of persistent atrial fibrillation.


Eligibility criteria:
inclusion criteria: * patients with recurrence of symptomatic persistent atrial fibrillation after at least one ablation procedure, * with the last ablation procedure at least 3 months ago. * at least one unsuccessful attempt of antiarrhythmic drug * oral anticoagulation for at least 4 weeks prior to ablation exclusion criteria: * la thrombus

Keywords: atrial fibrillation recurrence repeat procedure linear ablation stepwise approach
pain perception in protection of the palatal donor area after harvesting a free gingival graft using flowable resin versus a self-adhesive dressing

Conditions: Perception of Pain; Protection of the Palate

Summary: the use of a connective tissue graft harvested from the palate is currently one of the most effective and predictable alternatives for the correction of periodontal and peri-implant defects, but the discomfort generated in the palate is sometimes greater than mucogingival surgery. for this reason, we found the need to use different materials for palatal protection. in one group we will use light-cured fluid resin compared to another group a self-adhesive dressing to check which of these materials provides less postoperative pain generated by the harvest of a free gingival graft.

the postoperative pain generated by the harvest of a free gingival graft for the correction of periodontal or peri-implant defects, it\&#39;s greater when it is not adequately protected and until the reepithelialization of the area is complete. for this reason, it was decided to use two materials to compare the effectiveness in reducing postoperative pain in grafts larger than 15 mm. a control group will be treated with a hemostatic collagen sponge and photocured fluid resin, adhered to the palatal surfaces of the neighboring teeth using an adhesive protocol and x-shaped sutures. another experimental group will be treated with a hemostatic sponge and placement of a self-adhesive dressing stabilized by x-shaped sutures to ensure its permanence in the mouth. the participants will fill out a daily visual analog scale form for 14 days until the removal of the materials. finally, the results will be tabulated and compared to provide a conclusion of our study.

Eligibility criteria:
inclusion criteria: * patients over 18 years of age * patients with plaque control less than 20% * patients with bleeding on probing less than 10% * patients in need of periodontal or peri-implant surgery in the upper or lower jaw * not having previous surgeries in the donor area exclusion criteria: * pregnant or breastfeeding patients * patients with lesions in the palate * patients who use prostheses that cover the palate * patients with active periodontal disease * patients who smoke * patients with systemic diseases * torus palatinus * patients with a history of chemotherapy and radiotherapy

Keywords: protection of the palate pain palate flow resine self-adhesive dressing
c2rx hemofiltration treatment in severe or critically ill adults with covid-19

Conditions: Continuous Renal Replacement Therapy; Pulmonary Edema; COVID-19

Summary: the clinical trial will evaluate the short term and extended impact on on respiration, pulmonary function and cardiovascular function in c2rx treatment verse standard of care (soc) in critically ill adults with covid-19 infections .


Eligibility criteria:
inclusion criteria: * a patient, or legal authorized representative (lar), has provided informed consent and a written informed consent form. * positive covid-19 test. * must be receiving medical care in an intensive care nursing situation. * respiratory failure due to covid-19 disease requiring invasive mechanical ventilation. this care may include but is not required to include the use of dexamethasone. * within 18 hours of tracheal intubation to support invasive mechanical ventilation. a goal of this study is that t0 will occur within 24 hours of tracheal intubation to support invasive mechanical ventilation. * age 18 to 80 years. * males and females (females of childbearing potential who are not pregnant confirmed by a negative serum pregnancy test) and not lactating if recently post-partum). * intent to deliver full supportive care through aggressive management utilizing all available therapies for a minimum of 96 hours. exclusion criteria: * cardiovascular instability that precludes initiation of hemofiltration. * irreversible brain damage based on available historical and clinical information. * presence of any solid organ transplant at any time. * patients with stem cell transplant in the previous 100 days or who have not engrafted. * acute or chronic use of circulatory support device such as extracorporeal membrane oxygenation (ecmo), left ventricular assist devices (lvads), right ventricular assist devices (rvads), biventricular assist devices (bivads). * metastatic malignancy which is actively being treated or may be treated with chemotherapy or radiation during the subsequent three-month period after study treatment. * chronic immunosuppression defined as use of any immunosuppressant medications (cyclophosphamide, azathioprine, methotrexate, rituximab, mycophenolate, cyclosporine); prednisone use is excepted. * patient is moribund or chronically debilitated for whom full supportive care is not indicated. * concurrent enrollment in another interventional clinical trial except trials of covid-19 convalescent plasma, anti-severe acute respiratory syndrome (sars)-cov2 monoclonal antibodies, or remdesivirtm. patients enrolled in observational studies (without the use of an investigative device or drug), are allowed to participate. any communication between the principal investigator (pi) of this protocol and the pi of any other clinical study will include the medical director of the sponsor; all such correspondence will be documented. * any reason the investigator deems exclusionary